A global consensus meeting was held to review current evidence and knowledge gaps and propose collaborative studies on population-wide screening and eradication of
for prevention of gastric cancer ...(GC).
28 experts from 11 countries reviewed the evidence and modified the statements using the Delphi method, with consensus level predefined as ≥80% of agreement on each statement. The Grading of Recommendation Assessment, Development and Evaluation (GRADE) approach was followed.
Consensus was reached in 26 statements. At an individual level, eradication of
reduces the risk of GC in asymptomatic subjects and is recommended unless there are competing considerations. In cohorts of vulnerable subjects (eg, first-degree relatives of patients with GC), a screen-and-treat strategy is also beneficial.
eradication in patients with early GC after curative endoscopic resection reduces the risk of metachronous cancer and calls for a re-examination on the hypothesis of 'the point of no return'. At the general population level, the strategy of screen-and-treat for
infection is most cost-effective in young adults in regions with a high incidence of GC and is recommended preferably before the development of atrophic gastritis and intestinal metaplasia. However, such a strategy may still be effective in people aged over 50, and may be integrated or included into national healthcare priorities, such as colorectal cancer screening programmes, to optimise the resources. Reliable locally effective regimens based on the principles of antibiotic stewardship are recommended. Subjects at higher risk of GC, such as those with advanced gastric atrophy or intestinal metaplasia, should receive surveillance endoscopy after eradication of
.
Evidence supports the proposal that eradication therapy should be offered to all individuals infected with
. Vulnerable subjects should be tested, and treated if the test is positive. Mass screening and eradication of
should be considered in populations at higher risk of GC.
Intraarticular hyaluronan or platelet-rich plasma (PRP) is widely used in the treatment of knee osteoarthritis (OA). The efficacy of combined hyaluronan with PRP remained inconclusive. This study ...aimed to investigate the efficacy of combined a single crosslinked hyaluronan (HYAJOINT Plus) and a single PRP versus a single PRP in patients with knee OA. In a prospective randomized-controlled trial, 85 patients with knee OA (Kellgren-Lawrence 2) were randomized to receive a single intraarticular injection of HYAJOINT Plus (3 ml, 20 mg/ml) followed by 3 ml PRP (the combined-injection group, N = 43) or a single injection of 3 ml PRP (the one-injection group, N = 42). The primary outcome was the change from baseline in the visual analog scale (VAS) pain (0-00 mm) at 6 months. Secondary outcomes included The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC, Likert Scale), Lequesne index, single leg stance test (SLS), use of rescue analgesics and patient satisfaction at 1, 3 and 6 months. Seventy-eight patients were available for the intention-to-treat analysis at 6 months. Both groups improved significantly in VAS pain, WOMAC, Lequesne index and SLS at each follow-up visit (p < 0.001). Patients receiving a single PRP experienced significantly greater improvements in VAS pain than patients receiving combined injections at 1-month follow-up (adjusted mean difference: - 5.6; p = 0.017). There were no significant between-group differences in several of the second outcomes at each follow-up visit, except the WOMAC-pain and WOMAC-stiffness scores favoring the one-injection group at 1 month (p = 0.025 and p = 0.011). However, at 6-month follow-up, the combined-injection group achieved significantly better VAS pain reduction (p = 0.020). No serious adverse events occurred following injections. In conclusion, either combined injections of HYAJOINT Plus and PRP or a single PRP alone was safe and effective for 6 months in patients with Kellgren-Lawrence 2 knee OA. Combined injections of HYAJOINT Plus and PRP achieved better VAS pain reduction than a single PRP at 6 months. The results indicating a long term benefit effect of a combination of HYAJOINT Plus and PRP in a particular subset of patients with moderate knee OA need to be replicated in larger trials.ClinicalTrials.gov number NCT04315103.
The increase in the prevalence of antibiotic-resistant bacteria has become a major public health concern. Antimicrobial peptides (AMPs) are emerging as promising candidates addressing this issue. In ...this study, we designed several AMPs by increasing α-helical contents and positive charges and optimizing hydrophobicity and amphipathicity in the Sushi 1 peptide from horseshoe crabs. A neural network-based bioinformatic prediction tool was used for the first stage evaluations of peptide properties. Among the peptides designed, Sushi-replacement peptide (SRP)-2, an arginine-rich and highly α-helical peptide, showed broad-spectrum bactericidal activity against both Gram-positive and Gram-negative bacteria, including methicillin-resistant Staphylococcus aureus and multidrug-resistant Acinetobacter baumannii; nevertheless, it showed little hemolytic and cytotoxic activity against mammalian cells. Atomic force microscopy results indicated that SRP-2 should interact directly with cell membrane components, resulting in bacterial cell death. SRP-2 also neutralized LPS-induced macrophage activation. Moreover, in an intraperitoneal multidrug-resistant A. baumannii infection mouse model, SRP-2 successfully reduced the bacterial number in ascitic fluid and tumor necrosis factor-α production. Our study findings demonstrate that bioinformatic calculations can be powerful tools to help design potent AMPs and that arginine is superior to lysine for providing positive charges for AMPs to exhibit better bactericidal activity and selectivity against bacterial cells.
The rising prevalence of antibiotic resistance and the long‐term safety following eradication therapy are important issues in the management of Helicobacter pylori infection. The prevalence of ...clarithromycin, levofloxacin, and metronidazole resistance of H. pylori has increased to 21%, 27%, and 45%, respectively, in the Asia‐Pacific region. Personalized treatment guided by susceptibility testing may provide a reliably excellent eradication rate in the first‐line treatment but is costly and not widely available. Population‐specific empirical therapy according to the local prevalence of antibiotic resistance may be an alternative strategy. Levofloxacin‐based therapy and bismuth quadruple therapy are the recommended second‐line rescue therapy. Susceptibility testing or genotypic resistance‐guided therapy is the preferred treatment for refractory H. pylori infection, but empirical therapy may be an acceptable alternative. Eradication of H. pylori leads to short‐term perturbation of gut microbiota. The diversity of gut microbiota can be restored months after eradication therapy, but the speed of recovery varies with regimens. The short‐term increases of antibiotic resistance of Escherichia coli and Klebsiella pneumoniae may be restored to basal states months after H. pylori eradication. Future studies that apply in‐depth sequencing, such as shotgun metagenomics sequencing, are needed to clarify whether the compositions of gut microbiota at the species level are fully restored.
Graphene, with cracks filled with gold nanoparticles, is grown by chemical vapor deposition on a Cu substrate. The crack‐filled graphene not only exhibits superior electrical properties but also ...forms a better junction with other semiconductors. A high‐quality crack‐filled graphene/Si Schottky junction solar cell is achieved, demonstrating the highest fill factor (0.79) and best efficiency (12.3%).
Multiferroics—materials that exhibit coupled ferroic orders—are considered to be one of the most promising candidate material systems for next‐generation spintronics, memory, low‐power ...nanoelectronics and so on. To advance potential applications, approaches that lead to persistent and extremely fast functional property changes are in demand. Herein, it is revealed that the phase transition and the correlated ferroic orders in multiferroic BiFeO3 (BFO) can be modulated via illumination of single short/ultrashort light pulses. Heat transport simulations and ultrafast optical pump‐probe spectroscopy reveal that the transient strain induced by light pulses plays a key role in determining the persistent final states. Having identified the diffusionless phase transformation features via scanning transmission electron microscopy, sequential laser pulse illumination is further demonstrated to perform large‐area phase and domain manipulation in a deterministic way. The work contributes to all‐optical and rapid nonvolatile control of multiferroicity, offering different routes while designing novel optoelectronics.
All‐optical manipulation of the complex phases and domain structures in multiferroic BiFeO3 thin films on ultrafast timescale is demonstrated by adoption of extremely short light pulses. The configuration of large‐area optically written domains can be controlled by tuning the competing elastic and electrostatic energies. These results offer a novel route for the development of all‐optical switchable devices and high‐speed multifunctional optoelectronics.
Metal‐organic frameworks (MOFs) have recently emerged as attractive materials for their tunable properties, which have been utilized for diverse applications including sensors, gas storage, and drug ...delivery. However, the high porosity and poor electrical conductivity of MOFs restrict their optoelectronic applications. Owing to the inherent tunability, a broadband photon absorbing MOF can be designed. Combining the superior properties of the MOFs along with ultrahigh carrier mobility of graphene, for the first time, this study reports a highly sensitive, broadband, and wearable photodetector on a polydimethylsiloxane substrate. The external quantum efficiency of the hybrid photodetector is found to be >5 × 108%, which exceeds all the reported values of similar devices. The porosity of the MOF and ripple structure graphene can assist the trapping of photons at the light‐harvesting layer. The device photoresponsivity is found to be >106 A W−1 with a response time of <150 ms, which is approximately ten times faster than the current standards of the graphene‐organic hybrid photodetectors. In addition, utilizing the excellent flexibility of the graphene layer the wearability of the devices with stretchability up to 100% is demonstrated. The unique discovery of MOF‐based high‐performance photodetectors opens up a new avenue in organic–inorganic hybrid optoelectronics.
Strontium‐based metal‐organic frameworks (MOFs) hybridized with graphene ripples are first time utilized to design and demonstrate trapped photons induced ultrahigh external quantum efficiency and photoresponsivity wearable broadband photodetectors. The new discovery of flexible and stretchable MOF–graphene hybrid photodetector will not only open new perspectives for developing optoelectronics, but it also opens up an excellent alternative route for wearable electronics.
Clinical manifestations of phlebosclerotic colitis (PC) exhibit significant variability, necessitating diverse treatment strategies depending on disease severity. However, there is limited research ...exploring the relationship between imaging findings and disease severity. Hence, this retrospective study aimed to analyze the correlation between computed tomography (CT) findings, colonoscopic features, and disease severity. This study compared the abdominal CT characteristics, colonoscopy findings, and treatment modalities of 45 PC patients. CT images were assessed for the severity of mesenteric venous calcification, maximum colonic wall thickness, number of involved colonic segments, and presence of pericolic inflammation. Colonoscopic images were assessed for dark purple discoloration mucosa, erosive and ulcerative lesions, mucosal edema, luminal narrowing, and the number of involved colonic segments. In addition, patients were categorized into three groups: the observation (n = 15), medical treatment (n = 19), and operation (n = 11) groups. In CT images, a significant difference in pericolic inflammation (p = 0.039) was observed among groups. Further, significant differences in dark purple discoloration mucosa (p = 0.033), erosive or ulcerative lesions (p < 0.001), mucosal edema (p < 0.001), luminal narrowing (p = 0.012), and the number of involved colonic segments (p = 0.001) were observed in colonoscopy. Moreover, we found positive correlations between CT and colonoscopy features. In conclusion, CT manifestations and colonoscopy findings exhibited correlation with disease severity in PC. When limited to one diagnostic tool, observations from that tool can infer potential manifestations of the alternative tool.
Hybrid quantum dot–graphene photodetectors have recently attracted substantial interest because of their remarkable performance and low power consumption. However, the performance of the device ...greatly depends on the interfacial states and photogenerated screening field. As a consequence, the sensitivity is limited and the response time is relatively slow. In order to circumvent these challenges, herein, a composite graphene and graphene quantum dot (GQD) photodetector on lead zirconate titanate (Pb(Zr0.2Ti0.8)O3) (PZT) substrates has been designed to form an ultrasensitive photodetector over a wide range of illumination power. Under 325 nm UV light illumination, the device shows sensitivity as high as 4.06 × 109 A W−1, which is 120 times higher than reported sensitivity of the same class of devices. Plant derived GQD has a broad range of absorptivity and is an excellent candidate for harvesting photons generating electron–hole pairs. Intrinsic electric field from PZT substrate separates photogenerated electron–hole pairs as well as provides the built‐in electric field that causes the holes to transfer to the underlying graphene channel. The composite structure of graphene and GQD on PZT substrate therefore produces a simple, stable, and highly sensitive photodetector over a wide range of power with short response time, which shows a way to obtain high‐performance optoelectronic devices.
The permanent polarization of piezoelectric substrate (PZT) parallel to the built‐in electric field (DPZT) in the composite graphene and graphene quantum dot photodetector device assists efficient transfer of photogenerated holes to the graphene channel thus enhancing the photoresponsivity more than 100 times with ten times faster response compared to the device on SiO2 substrate. In contrast, opposite PZT polarization in UPZT devices abates the photoresponsivity with slower response time.
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